COBRA, HIPAA, FMLA, ADA Certification And More
COBRA & Sec 125 Software
COBRA, HIPAA, Sec 125 Compliance Seminars
For Insurance Agents
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| Who Is Eligible |
Certain individuals may elect to receive COBRA continuation coverage when they have a COBRA Qualifying Event (QE). These individuals are called Qualified Beneficiaries (QBs), and include:
- Any
individual who on the day before a Qualifying Event is
covered under a group health plan
- Regardless
of the date of the QE, children born to, or placed for
adoption with, the covered employee during the covered
employee’s COBRA coverage period. (Note: This rule
applies only to children born to, or placed for adoption
with, covered employees, and not other QB’s.), or
- In the
event of a bankruptcy by the employer, a covered employee
who has retired on or before the date of the substantial
elimination of the group health benefits coverage is also
a QB, as well as his/her spouse, surviving spouse, or
dependent child if on the day before the bankruptcy QE,
these individuals were beneficiaries under the group
health plan.
If an employee is covered by a COBRA-governed plan, even for one day, COBRA coverage must be made available to the QB’s if a QE occurs and that covered employee loses plan coverage because of that QE.
Every QB loses coverage due to a QE, and regardless of the date of the every child born to, or placed for adoption with, the "covered employee" during the "covered employee’s" COBRA coverage period, is entitled to elect to purchase continued health coverage equivalent to the coverage available to similarly situated non-COBRA beneficiaries who have not experienced a QE.
The following individuals can become QBs under COBRA:
- An employee
- A former employee
- A retired employee
- The dependent children of any of the above (including adopted and placed for adoption children)
- The spouse of any of the above
- Children covered by the plan pursuant to Qualified Medical Child Support Orders
- Individuals who are covered by the plan who are self-employed persons, agents or independent contractors (and their employees, agents, and independent contractors), and corporate directors.
Note: The right to elect this continued coverage may not be conditioned on the QB's insurability.
Each QB affected by a QE has separate COBRA election rights. For example, a family of four covered individuals represents four separate potential QBs who each have independent COBRA rights. And remember, regardless of the date of the QE, children born to, or placed for adoption with, the covered employee during the employee’s COBRA coverage period also are QBs who each have independent COBRA rights.
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